Plasma hsCRP Concentrations Research Articles

Adalimumab Treatment Effects on Inflammation and Adipose Tissue Mitochondrial Respiration in Hidradenitis Suppurativa.

Tumour necrosis factor (TNF)-α is a proinflammatory marker and has been shown to affect mitochondrial function in different tissues. We investigated the effect on adipose tissue (AT) inflammation and mitochondrial respiration in patients with hidradenitis suppurativa (HS) after 12 weeks of treatment with adalimumab, a TNF-α inhibitor. We sampled blood and an AT biopsy from 13 patients with HS and 10 control subjects after an overnight fast. The patients were retested after at least 12 weeks of treatment with adalimumab (40 mg/week). We measured macrophage content and mitochondrial respiration in the AT and interleukin (IL)-1β, IL-6, IL-10, high-sensitivity C-reactive protein (hsCRP), interferon-γ, TNF-α, adiponectin and leptin in plasma. Clinical scores and Dermatology Quality of Life Index (DLQI) were assessed. We found a higher anti-inflammatory macrophage content (CD206+) in the patient group compared with the control group, but no differences between before and after the intervention. No difference in mitochondrial respiration was observed. We observed higher plasma IL-6 and hsCRP concentrations in patients with HS compared to controls, with no differences before and after the intervention. The difference between controls and HS patients was abolished after the intervention. HS patients improved their DLQI after the intervention with no change in clinical scores. Treatment with adalimumab in patients with HS does not alter AT inflammation or mitochondrial respiratory capacity; however, we did see a higher content of anti-inflammatory macrophages in the patient group compared with the control group.

Clinical response to EPA supplementation in patients with major depressive disorder is associated with higher plasma concentrations of pro-resolving lipid mediators

Chronic inflammation has been implicated in the pathophysiology of major depressive disorder (MDD). Activating the resolution of inflammation through ω-3 fatty acid supplementation may prove to be a successful therapeutic strategy for the treatment of MDD. Patients with MDD, body mass index >25 kg/m2, and plasma high-sensitivity C-reactive protein ≥3 μg/mL (n = 61) were enrolled in a 12-week randomized trial consisting of 4 parallel arms: EPA 1, 2, and 4 g/d, and placebo. The supplement contained EPA and DHA in a 3.9:1 ratio. Depression symptoms were assessed using the IDS-C30 scale. Plasma fatty acids and pro-resolving lipid mediators (SPMs) were measured in 42 study completers at baseline and at the end of treatment by liquid chromatography/mass spectrometry. The response rate (≥50% reduction in IDS-30 score) was higher in the 4 g/d EPA arm than placebo (Cohen d = 0.53). In the 4 g/d EPA arm, responders had significantly greater increases in 18-hydroxyeicosapentaenoic acid (18-HEPE) and 13-hydroxydocosahexaenoic acid (13-HDHA) than non-responders (p < 0.05). Within the 4 g/d EPA arm, the increase in 18-HEPE was significantly associated with reductions in plasma hs-CRP concentrations (p < 0.05) and IDS-C30 scores (p < 0.01). In summary, response rates were greater among patients with MDD randomized to EPA 4 g/d supplementation and in those who showed a greater ability to activate the synthesis of 18-HEPE. The inverse association of 18-HEPE with both systemic inflammation and symptoms of depression highlights the activation of the resolution of inflammation as a likely mechanism in the treatment of MDD with ω-3 fatty acid supplementation.

Plasma levels of soluble urokinase plasminogen activator receptor (suPAR) and high-sensitivity C-reactive protein after Roux-en-Y gastric bypass or sleeve gastrectomy: a 1-year prospective observational study.

Low-grade inflammation in obesity contributes to the development of cardiovascular disease, diabetes mellitus and cancer, and is associated with increased mortality. The purpose of this 1-year prospective observational study was to examine the weight loss effect of bariatric surgery on plasma concentrations of two inflammatory markers, namely high-sensitivity C-reactive protein (hsCRP) and soluble urokinase-type plasminogen activator receptor (suPAR), in patients with obesity. Sixteen subjects without obesity and 32 patients with obesity class III, who had already settled upon Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were included in the study. Subjects without obesity were examined once, at baseline; patients with obesity were examined preoperatively (baseline) and 3, 6 and 12months postoperatively. Plasma suPAR and hsCRP concentrations at baseline were higher in patients with obesity than in lean participants (2.68 ± 0.86 vs 1.86 ± 0.34ng/mL, p < 0.001 and 9.83 ± 9.55 vs 1.36 ± 1.95mg/dL, p < 0.001). Levels of suPAR following bariatric surgery increased significantly 3months after either RYGB or SG (3.58 ± 1.58 vs 3.26 ± 0.7ng/mL, respectively) and declined at 6 (3.19 ± 1.75 vs 2.8 ± 0.84ng/mL, respectively) and 12months (2.6 ± 1.5 vs 2.22 ± 0.49ng/mL, respectively; p < 0.05 for the effect of time on suPAR levels during the study), whereas those of hsCRP declined consistently after bariatric surgery (3months: 5.44 ± 3.99 vs 9.47 ± 11.98mg/dL, respectively; 6months; 5.39 ± 5.6 vs 10.25 ± 17.22mg/dL, respectively; and 12months: 2.23 ± 2.5 vs 3.07 ± 3.63mg/dL, respectively; p < 0.001 for the effect of time on hsCRP levels during the study). 1-year change in BMI was negatively associated with suPAR levels at 12months. Our findings support an association between obesity and low-grade inflammation. Weight loss following bariatric surgery is associated with a consistent decline in plasma hsCRP, while plasma suPAR levels increase at 3months and decline by 12months.

370 Dietary soluble fiber increases the intestinal butyrate-producing bacteria, reduces intestinal permeability, and improves metabolic syndrome in sows during perinatal period

Abstract In humans, metabolic and immune changes during the perinatal period also describe metabolic syndrome. Gut microbiota can cause symptoms of metabolic syndrome in pregnant women. Gut microbiota modulations caused by pregnancy nutrition constitute an interesting target in the metabolic status of pregnant individual. However, studies investigating the changes of the metabolic characteristics and gut microbiota in sows throughout pregnancy and lactation are lacking, and the effects of soluble fiber diet during pregnancy on them are still underexplored. Sows were allocated to either control or 2.0% pregelatinized waxy maize starch plus guar gum (SF) dietary treatment during gestation. The metabolic characteristics, gut permeability and inflammation status, and gut microbiota composition and metabolism of sows during pregnancy and lactation were analysed. The plasma levels of hs-CRP and HOMA-IR values were increased in days 109 of gestation (G109) and days 3 of lactation (L3), while dietary SF reduced plasma hs-CRP concentrations and the HOMA-IR values. The levels of plasma zonulin and fecal endotoxin and lipocalin-2 were increased in G109 and L3, while dietary SF reduced elevation of plasma zonulin and endotoxin and fecal lipocalin-2. Next-generation sequencing analysis revealed that dietary SF increased levels of butyrate-producing Ruminococcaceae, Lachnospiraceae, and Oscillospira. The fecal and plasma levels of butyrate were also increased. Additionally, the increased relative abundances of Lachnospiraceae in SF sows negatively correlated with plasma hs-CRP and HOMA-IR while Oscillospira was negatively fecal lipocalin-2. Our data reveal that the sow exhibits a metabolic syndrome and dramatical changes in gut microbiota during perinatal period. Besides, dietary SF has beneficial effects on insulin sensitivity, intestinal permeability and inflammation maybe via increasing butyrate-producing bacteria and butyrate production.

Supervised Short-term High-intensity Training on Plasma Irisin Concentrations in Type 2 Diabetic Patients.

Irisin is a myokine involved in adipocyte transformation. Its main beneficial effects arise from increased energy expenditure. Irisin production is particularly stimulated by physical exercise. The present study investigates the changes of plasma irisin in type 2 diabetic patients performing 2 different training modalities. Fourteen type 2 diabetic patients underwent 4 week of supervised high-intensity interval training (HIT; n=8) or continuous moderate-intensity training (CMT; n=6), with equivalent total amounts of work required. Plasma samples were collected in the resting state atbaseline and one day after the exercise intervention to analyse resting plasma irisin, blood lipids, blood glucose, hsCRP, Adiponectin, Leptin and TNF-α concentrations. In addition, body composition and VO2peak were determined Resting plasma irisin increased after HIT (p=0.049) and correlated significantly with plasma fasting glucose at follow-up (r=0.763; p=0.006). CMT did not significantly change the amount of plasma irisin, although follow-up values of plasma irisin correlated negatively with fat-free mass (r=-0.827, p=0.002) and with fasting plasma glucose (r = - 0.934, p=0.006). Plasma irisin was found to increase with higher training intensity, confirming the assumption that exercise intensity, in addition to the type of exercise, may play an important role in the stimulation of the irisin response.

The role of high high-sensitivity C-reactive protein levels at admission on poor prognosis after acute ischemic stroke

Objective: Plasma high hypersensitive C-reactive protein (hs-CRP) levels are associated with risk and prognosis of vascular diseases. The clinical implications of markedly elevated hs-CRP levels are more discovered in the onset and development of stroke. The aim of this study is to determine the association of plasma hs-CRP levels on the prognosis in patients with acute ischemic stroke.Methods: Retrospective analysis of a single-center database of consecutive cases for acute cerebral infarction (ACI) from January 1 2012 to December 30 2016 was performed. Significant predictors of the dependent variable variance were identified by standard linear, univariate and multivariate, or binary logistic regression modeling. Multivariate regression analysis was introduced to investigate the relationship between plasma hs-CRP levels at admission and change in National Institutes of Health Stroke Scale (NIHSS) score at discharge.Results: The percentages of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, body mass index (BMI) and chronic kidney disease were raised with the increase of hs-CRP plasma concentration at admission among all patients (p < 0.05). ACI patients with large-artery atherosclerosis had an increasing percentage with the increase of hs-CRP mean value (p < 0.05). The initial NIHSS scores, the acute infection rate and age advance also increased with the increase of hs-CRP plasma concentration at admission (p < 0.05). The ratio of neurological improvement increased with the decrease of plasma hs-CRP concentration (p < 0.05). The neurological deterioration and poor prognosis increased with the increase of plasma hs-CRP concentration (p < 0.05).Conclusion: High plasma hs-CRP levels are associated with worse outcomes in the ACI patients. Monitoring plasma hs-CRP levels and cutting down the elevated plasma hs-CRP levels will be beneficial in screening and treatment decisions for the prognosis of acute ischemic stroke.

A11100 Effects of Chronic Salt Loading on Plasma Inflammatory Factors in Normotensive Adults

Objectives: To observe the effects of dietary sodium intake on plasma inflammatory factors tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (CRP) and monocyte chemoattractant protein -1 (MCP-1) in normotensive adults. Methods: Thirty normotensive volunteers, aged 18 to 60, were selected to undergo a baseline survey, a low-sodium diet (51.3 mmol per day) for 7 days, a high-sodium diet (307.8 mmol per day) for an additional 7days. Thirty subjects were classified as salt sensitive group (SS, 10 subjects) or non-salt sensitive group (NSS, 20 subjects) on the basis of their mean arterial blood pressure (MAP) increase more than 10 percent at the end of the high-sodium phase compared with the low-sodium phase. Fasting blood samples were taken on the first day of baseline and on the sixth day of the two intervention phases. Plasma TNF-α and MCP-1 concentration was measured using an enzyme-linked immunosorbent assay system, plasma hsCRP concentration was measured by immune nephelometry. Results: The prevalence of SS is 33%. After salt loading, no significant change was found in the plasma hsCRP concentrations; Whereas plasma TNF-α level increased significantly in both of the two groups [(168.4 ± 67.8 vs. 42.1 ± 26.7)pg/ml, P < 0.01 and (129.8 ± 24.1 vs. 37.7 ± 15.8)pg/ml, P < 0.01, respectively]; Plasma MCP-1 was significantly higher during the high-sodium than the low-sodium phase in both of the two groups[(205.2 ± 64.2 vs. 166.3 ± 48.5)pg/ml, P < 0.01and (212.3 ± 52.2 vs. 143.6 ± 55.9)pg/ml, P < 0.01]. Conclusion: High-sodium diet can induce an inflammatory state, which may be independent of the salt sensitivity.

Abstract 426: Atherosclerotic Risk Factors Correlate with Carotid Intimal Media Thickness in Participants of the Childhood Obesity Study in South Texas: Preliminary Results

Rationale: The prevalence of childhood and adolescent obesity is increasing in the United States, where one-third of children and adolescents are affected. This is especially true in the Hispanic population. It is well known that obesity is positively associated with increased atherosclerosis, the primary cause of cardiovascular disease (CVD). Our study objective was to determine whether carotid intima-media thickness (CIMT) is associated with the severity of obesity and cardiovascular risk factors in obese Hispanic adolescents in San Antonio, Texas. We present for the first time, preliminary results for an on-going, Childhood Obesity Study at The Children’s Hospital of San Antonio, where obese children in South Texas are referred for weight management. Methods: We present data for 36 obese subjects (males= 21) with an average % of the CDC 95 th BMI percentile of 139 at baseline (first clinic visit). The mean age was 15 + 1 years. We assessed cardiovascular risk factors and measured CIMT using B-mode ultrasonography on the left and right carotid arteries. For each patient, we calculated mean CIMT for carotid internal artery, common carotid artery, and carotid bulb, and the mean for all the CIMT measurements. Results: There were no age-sex differences in BMI, plasma LDL-C, high sensitivity C-reactive protein (hs-CRP) and CIMT. The mean CIMT for the common carotid artery (CIMT-CCA), carotid internal artery (CIMT-CIA), and carotid bulb (CIMT-CB) were 0.50±0.12, 0.43±0.22, and 0.60±0.29 mm respectively. BMI correlated with CIMT-CIA (p= 0.012) and CIMT-CB (p= 0.002). The correlation remained significant with the means of all the CIMT measurements (p= 0.002). Plasma hs-CRP and LDL-C concentrations correlated with CIMT-CIA (p= 0.045) and the means for all CIMT measurements (p= 0.027). We did not observe significant correlations with CIMT for the common carotid artery. Conclusion: Cardiovascular risk factors assessed in adolescents who are obese correlate with CIMT, a surrogate for atherosclerotic burden, suggesting that these obese adolescents have early onset atherosclerosis. Our results are preliminary and should be interpreted cautiously.

Plasma phosphorylated neurofilament heavy chains as a potential marker for ischemic stroke patients

Abstract Background: The aim of the study was to determine the utility of plasma NfH in correlation with serum hsCRP for severity and short-term functional outcome prediction after ischemic stroke. Methods: 124 patients and 40 healthy controls were enrolled, serial plasma neurofilament heavy chains and hsCRP concentrations were measured and evaluated for TOAST subtype, stroke severity and functional outcome at discharge. Results: Serum level of hsCRP was significantly higher in patients versus controls (p&lt;0.05) with no difference between TOAST subtypes. Plasma NfH concentration on day 5 was higher in CE stroke compared to LAA group and SVO group. A positive correlation between NfH levels on day 5 and mRS at discharge (r=0.304, p=0.001) and a gender stratification of hsCRP and mRS at discharge was found. Values of 6.04 mg/l for hsCRP and 46.4 ng/ml for NfH were found predictive for unfavorable short-term outcome, but after adjusting for age, sex and stroke severity, the prediction power was lost. Conclusions: Plasma concentration of NfH shows a significant increase over the first five days after ischemic stroke, in correlation with inflammatory status and short-term evolution.

The Association between Galectin-3 and hs-CRP and the Clinical Outcome after Non-ST-Elevation Myocardial Infarction with Preexisting Atrial Fibrillation

Increased galectin-3 plasma concentration has been linked to an unfavorable outcome in patients with heart failure or atrial fibrillation (AF). There are no published data about the prognostic utility of galectin-3 and high-sensitivity C-reactive protein (hs-CRP) for long-term clinical outcome in the Non-ST elevation acute myocardial infarction (NSTEMI) patients with preexisting AF. Thirty-two patients with the first acute NSTEMI and preexisting AF and 22 patients without preexisting AF, were prospectively followed for fifteen months. Patients with AF had significantly higher galectin-3 plasma levels (p < 0.05) and hs-CRP concentration (p < 0.01), compared with patients without AF. Galectin-3 plasma concentration was not a significant covariate of the composite outcomes (p = 0.913). Patients with high hs-CRP (above 4.55 mg/L) showed 2.5 times increased risk (p < 0.05) of the composite outcome occurrence (p < 0.05). Besides, three-vessel coronary artery disease, creatinine serum level, and creatinine clearance were significant covariates (p < 0.05; p < 0.05; p < 0.01) of the composite outcome, respectively. Creatinine clearance, solely, has been shown to be an independent predictor of unfavorable prognosis after a 15-month follow-up. Galectin-3 and hs-CRP plasma levels were elevated in NSTEMI patients with AF, but with differential predictive value for an unfavorable clinical outcome. Only hs-CRP was associated with increased risk of composite outcome occurrence.

Increased ratio of high sensitivity C-reactive protein to interleukin-10 as a potential peripheral biomarker of schizophrenia and aggression

BackgroundMany studies have indicated that immune dysfunction might be involved in the physiopathology of schizophrenia and aggression. This study aimed to investigate the correlation between high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-10 and clinical characteristics, especially aggression, and to explore the potential role of hsCRP and IL-10 as plasma biomarkers of schizophrenia. MethodsForty-one patients with schizophrenia and forty healthy individuals were enrolled. Psychopathological severity and aggression were assessed using the Positive and Negative Syndrome Scale (PANSS) and Modified Overt Aggression Scale (MOAS). Plasma concentrations of hsCRP and IL-10 were assessed by enzyme-linked immunosorbent assay (ELISA). Results(1) Higher levels of hsCRP (p<0.001), lower levels of logIL-10 (p<0.001) and higher ratio of hsCRP to IL-10 (p<0.001) were observed in the plasma of patients with schizophrenia, compared to healthy controls; (2) ROC (receiver operating characteristic) curve analysis revealed that ratio of hsCRP/IL-10 (predictive value: 0.783, p<0.01; sensitivity: 85.4%; specificity: 67.5%) was more applicable as a biomarker to distinguish patients with schizophrenia from the control group than hsCRP and IL-10 alone (predictive value: 0.718, p<0.01; 0.275, p<0.001, respectively); (3) we found positive correlations between hsCRP and the total score and verbal aggression score of MOAS (r=0.654, p<0.01; r=0.678, p<0.05), and between hsCRP/IL-10 and the total score of MOAS (r=0.636, p<0.01). ConclusionsOur results suggest the possible function of hsCRP and IL-10 in the pathogenesis of schizophrenia and the possible value of hsCRP/IL-10 as a potential peripheral biomarker of schizophrenia. This finding also suggests a relationship between hsCRP, IL-10 and their ratio with aggression in patients with schizophrenia.

Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with Biomarkers of Inflammation and Oxidative Balance in Adults

Background:Chronic inflammation and oxidative balance are associated with poor diet quality and risk of cancer and other chronic diseases. A diet–inflammation/oxidative balance association may relate to evolutionary discordance.Objective:We investigated associations between 2 diet pattern scores, the Paleolithic and the Mediterranean, and circulating concentrations of 2 related biomarkers, high-sensitivity C-reactive protein (hsCRP), an acute inflammatory protein, and F2-isoprostane, a reliable marker of in vivo lipid peroxidation.Methods:In a pooled cross-sectional study of 30- to 74-y-old men and women in an elective outpatient colonoscopy population (n = 646), we created diet scores from responses on Willett food-frequency questionnaires and measured plasma hsCRP and F2-isoprostane concentrations by ELISA and gas chromatography–mass spectrometry, respectively. Both diet scores were calculated and categorized into quintiles, and their associations with biomarker concentrations were estimated with the use of general linear models to calculate and compare adjusted geometric means, and via unconditional ordinal logistic regression.Results:There were statistically significant trends for decreasing geometric mean plasma hsCRP and F2-isoprostane concentrations with increasing quintiles of the Paleolithic and Mediterranean diet scores. The multivariable-adjusted ORs comparing those in the highest with those in the lowest quintiles of the Paleolithic and Mediterranean diet scores were 0.61 (95% CI: 0.36, 1.05; P-trend = 0.06) and 0.71 (95% CI: 0.42, 1.20; P-trend = 0.01), respectively, for a higher hsCRP concentration, and 0.51 (95% CI: 0.27, 0.95; P-trend 0.01) and 0.39 (95% CI: 0.21, 0.73; P-trend = 0.01), respectively, for a higher F2-isoprostane concentration.Conclusion: These findings suggest that diets that are more Paleolithic- or Mediterranean-like may be associated with lower levels of systemic inflammation and oxidative stress in humans.

The relationship between fasting plasma glucose and MPO in patients with acute coronary syndrome.

BackgroundInflammation plays a critical role in the progression of atherosclerosis, and hyperglycemia is a common feature in patients with ACS. We investigated the relationship between fasting plasma glucose (FPG) levels and the levels of the inflammatory factor, myeloperoxidase (MPO), in patients with acute coronary syndrome (ACS).MethodA total of 85 patients with no prior history of diabetes mellitus were recruited. The patients were divided into three groups based on their FPG levels as follows: group A, FPG < 5.6 mmol/l; group B, 5.6 mmol/l ≤ FPG < 6.1 mmol/l; and group C, FPG ≥ 6.1 mmol/l. The FPG concentrations and plasma MPO levels were determined, coronary angioplasty was performed, and the Gensini scores were used to evaluate the severity of the coronary lesion. The MPO expression in peripheral blood mononuclear cells (PBMCs) in patients with ACS was determined using western blot analysis.ResultThe results demonstrated that the levels of FPG were significantly and positively correlated with plasma MPO levels, Gensini scores, high sensitive C reaction protein(hs-CRP)levels, leukocyte and neutrophils count. In multivariate regression analyses the FPG levels were positively correlated with plasma MPO levels, Gensini score and hs-CRP. The plasma MPO levels in the group C [68.68(52.62–91.88) U/L] were significantly higher than in the group A [63.04(26.18–97.75) U/L] and group B [58.22(23.95–89.54) U/L]. The plasma hs-CRP concentrations are also higher in group C [42.28 (0.31–169.40) mg/L] than in the group A [12.51(0.28–176.25) mg/L] and group B [14.7 (0.14–89.68) mg/L].ConclusionThis study demonstrates that FPG values are positively correlated with plasma MPO levels, suggesting MPO may play a role in the proatherogenesis of high FPG.

Relationships of High-sensitive C-reactive Protein and P-wave Dispersion in Lone Atrial Fibrillation.

Background:Current evidence links atrial fibrillation (AF) to the inflammation. Inflammatory indexes such as high-sensitive C-reactive protein (hs-CRP) have been related to the development and persistence of AF. However, the role of inflammation in the atrial electrophysiological remodeling indexed by P-wave dispersion (Pd) remains unclear.Methods:The study consisted of 71 patients with lone paroxysmal AF (AF group) and 71 age- and gender-matched controls of paroxysmal supraventricular tachycardia without history of AF (control group). Electrocardiography, Pd, hs-CRP, and other clinical characteristics were compared between the two groups.Results:There was no significant difference between the two groups regarding age, gender, hyperlipidemia, etc. Compared to controls, left atrial diameter (44 ± 7 vs 39 ± 7 mm), Pd (49 ± 13 vs 26 ± 8 ms), and hs-CRP (2.17 [1.46–2.89] vs 1.12 [0.74–1.41] mg/L) were increased (P < 0.05), respectively. Linear regression identified hs-CRP as an independent correlation of Pd level both in the total population and the AF group (r = 0.464 and 0.313; P < 0.001, respectively). Multiple logistic regression revealed hs-CRP as an independent determinant of AF (odds ratio [OR] =15.430, 95% confidence interval: 6.031–39.476: P <0.001). Further adjusted for Pd, both Pd and hs-CRP were independent predictors for AF, but the OR for hs-CRP in predicting AF has been attenuated from 15.430 to 6.246.Conclusions:In lone AF, Pd and plasma hs-CRP concentration are inter-associated and related to AF. The interaction between hs-CRP and AF may be mediated by Pd, suggesting an important role of inflammation in the atrial electrophysiological remodeling predisposing to AF.

Iron deficiency: Prevalence and relation to cardiovascular biomarkers in heart failure outpatients

BackgroundBoth iron deficiency (ID) and cardiovascular biomarkers are associated with a poor outcome in heart failure (HF). The relationship between different cardiovascular biomarkers and ID is unknown, and the true prevalence of ID in an outpatient HF clinic is probably overlooked. ObjectivesTo identify the prevalence of ID in a HF clinic and evaluate whether ID is associated with increased plasma concentrations of different cardiovascular biomarkers that carry a poor prognosis. MethodsWe prospectively included 149 patients with systolic HF referred to an outpatients HF clinic. ID was defined as ferritin<100μg/L or ferritin 100–300μg/L and Tranferin-saturation<0.20. Five different cardiovascular biomarkers were analyzed on frozen plasma. ResultsThe patients had a median age of 70 (Interquartile range: 64–75) years, 25% were females, 29% were in functional class III–IV and LVEF was 32 (27–39) %. The prevalence of ID was 45% (95%-confidence interval (CI): 37–53%). In multivariate analyses, ID was not associated with plasma concentrations of troponin I, NT-proBNP, MR-proANP, chromogranin A or copeptin (P>0.05 for all) but with plasma concentrations of hs-CRP (odds ratio: 2.03, 95%-CI: 1.02–4.02, P=0.043). ConclusionID is frequent in an outpatient HF clinic. ID is not associated with cardiovascular biomarkers after adjustment for traditional confounders. Inflammation, but not neurohormonal activation is associated with ID in systolic HF. Further studies are needed to understand iron metabolism in elderly HF patients

Interactions of genetic and non-genetic factors on plasma hs-CRP concentration in a Korean community-based cohort study

High sensitivity C-reactive protein (hs-CRP) level is a predictor of cardiovascular disease. We investigated gene-environment interactions that affect hs-CRP levels in a community-based cohort. We evaluated the effects of 11 non-genetic factors on hs-CRP level in 866 Korean elderly and performed single marker analyses of 25 single-nucleotide polymorphisms (SNPs) in eight loci (i.e. IL6R, CRP, GCKR, IL6, CYP17A1, HNF1A, APOE, and 12q23.2) under each of additive, dominant, and recessive genetic model. Finally, we evaluated gene-environment interactions using generalized linear models with adjusting for age, sex, and body mass index (BMI). The general linear model identified several non-genetic risk factors associated with hs-CRP level, the most significant examples of which are high BMI (β = 0.039, P = 5.3 × 10−6), total cholesterol to HDL cholesterol ratio (T/HDL, β = 0.072, P = 2.1 × 10−4), and current smoking status (β = 0.225, P = 0.005). Single SNP analyses for seven genes revealed strong evidence for associations that affect hs-CRP levels (P = 8.9 × 10−5 to 0.032). The interactions between IL6R (rs2228145) and both high T/HDL and systolic blood pressure (P G×E = 0.009 and 0.045, respectively), CRP (rs7553007) and sleeping less than 8 hours per day (P G×E = 4.0 × 10−4), IL6 (rs2097677) and current alcohol drinking (P G×E = 0.026), and HNF1A (rs1169288) with regular exercise (P G×E = 0.035) significantly increased the hs-CRP levels in the current study. Common susceptibility variants and their interactions with non-genetic factors affect the inter-individual variability of plasma hs-CRP concentrations.

Krill Oil for HIV-Related Inflammation: A Pilot Study

Abstract Background: Human immunodeficiency virus (HIV)–related inflammation has been associated with cardiovascular events in adults infected with the virus. Krill oil contains anti-inflammatory omega-3 fatty acids and has potential advantages as an anti-inflammatory agent, compared to fish oil. The aim of this research was to explore the safety and effect size (ES) of krill oil for reducing soluble inflammatory mediators in persons with HIV infection. Materials and Methods: This randomized, controlled, double-blinded clinical trial was conducted at an infectious disease outpatient clinic located in a medically underserved neighborhood in Chicago. The participants were 10 stable HIV-infected adults with elevated high-sensitivity C-reactive protein (hsCRP) concentrations in their sera (> 3 mg/dL). These participants received either 1 g/day of krill oil or placebo for 8 or 12 weeks. The primary outcome measures were efficacy measures, including plasma concentrations of hsCRP, d-dimer, and interleukin-6; an...

Effect of atorvastatin on exercise tolerance in patients with diastolic dysfunction and exercise-induced hypertension

To investigate the effect of atorvastatin on exercise tolerance in patients with diastolic dysfunction and exercise-induced hypertension. A randomized, double-blind, placebo-controlled prospective study was performed. Sixty patients with diastolic dysfunction (mitral flow velocity E/A <1) and exercise-induced hypertension (SBP>200 mm Hg) treated with atorvastatin (20 mg q.d) or placebo for 1 year. Cardiopulmonary exercise test and exercise blood pressure measurement were performed. Plasma B-natriuretic peptide (BNP) concentration at rest and at peak exercise, plasma high sensitive-C reaction protein (hs-CRP) and endothelin (ET) concentration were determined at baseline and after treatment. After treatment by atorvastatin, the resting SBP, pulse pressure, the peak exercise SBP and BNP were significantly decreased; and the exercise time, metabolic equivalent, maximal oxygen uptake and anaerobic threshold were increased. All of these parameters had significant differences with baseline levels (P<0.05) and the rest pulse pressure, the peak exercise SBP and BNP, and the exercise time had significant differences compared with placebo treatment (P<0.05). Plasma concentrations of hs-CRP and ET were markedly reduced by atorvastatin treatment compared with baseline and placebo (P<0.05). No difference in above parameters was found before and after placebo treatment (P>0.05). In patients with diastolic dysfunction at rest and exercise-induced hypertension, atorvastatin can effectively reduce plasma hs-CRP and ET level, lower blood pressure and peak exercise SBP, decrease peak exercise plasma BNP concentration, and ultimately improve exercise tolerance.

Dietary fatty acids and inflammatory markers in patients with coronary artery disease.

Background:Atherosclerosis, with its major manifestation, coronary artery disease (CAD) is a chronic inflammatory disease. Dietary fatty acids intakes favorably effect on inflammatory responses. This study was conducted to examine the association between dietary fatty acid intakes and inflammatory markers, interleukin 6 (IL-6) and high sensitivity C-reactive protein (hs-CRP), in CAD patients among Iranian population.Materials and Methods:This hospital-based, cross-sectional study was conducted in Chamran Heart Hospital, Isfahan, Iran in 2012. Patients aged ≥45 years with first ever symptomatic CAD confirmed by angiography were included. A semi-quantitative food frequency questionnaire (FFQ) was used to assess the usual intakes of dietary fatty acids.Results:The energy-adjusted daily intakes (mean ± SD) of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), linoleic acid, α-linolenic acid, and eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) were 27 ± 9, 22 ± 6, 21 ± 5, 0.4 ± 0.32, and 0.85 ± 0.82 g/d; respectively. After adjustment for potential confounders, SFA was directly related to hs-CRP (P = 0.01) and IL-6 (P < 0.001) concentrations. Intakes of EPA + DHA and MUFA, were significantly adversely related to plasma hs-CRP concentration (P = 0.002 and 0.001, respectively) but not IL-6, albeit MUFA was modestly inversely related to IL-6 (P = 0.08). No significant relationships were observed for other fatty acids, α-linolenic acid, and linoleic acid.Conclusions:These findings suggest that saturated fatty acids, EPA + DHA and MUFA were significantly related to plasma inflammatory markers in CAD patients.

Provision of Antioxidant Therapy in Hemodialysis (PATH)

Increased markers of oxidative stress and acute-phase inflammation are prevalent in patients undergoing maintenance hemodialysis therapy (MHD), and are associated with increased mortality and hospitalization rates and decreased erythropoietin responsiveness. No adequately powered studies have examined the efficacy of antioxidant therapies on markers of inflammation and oxidative stress. We tested the hypothesis that oral antioxidant therapy over 6 months would decrease selected biomarkers of acute-phase inflammation and oxidative stress and improve erythropoietic response in prevalent MHD patients. In total, 353 patients were enrolled in a prospective, placebo-controlled, double-blind clinical trial and randomly assigned to receive a combination of mixed tocopherols (666 IU/d) plus α-lipoic acid (ALA; 600 mg/d) or matching placebos for 6 months (NCT00237718); 238 patients completed the study. High-sensitivity C-reactive protein (hsCRP) and IL-6 concentration were measured as biomarkers of systemic inflammation, and F2 isoprostanes and isofurans were measured as biomarkers of oxidative stress. The groups did not significantly differ at baseline. At 3 and 6 months, the treatment had no significant effect on plasma hsCRP, IL-6, F2 isoprostane, or isofuran concentrations and did not improve the erythropoietic response. No major adverse events were related to the study drug, and both groups had similar mortality and hospitalization rates during the study. In conclusion, the administration of mixed tocopherols and ALA was generally safe and well tolerated, but did not influence biomarkers of inflammation and oxidative stress or the erythropoietic response.